AUSTRALIAN DOCTOR, Friday, 25 November 1994.

SENSITIVITY IS THE RISING ISSUE ON CIRCUMCISION

by

Dr. Sandra Pertot

The debate about circumcision is one that just does not
seem to want to go away.

After a long period of relative quiet in which the medical
position has been that circumcision is an unnecessary
operation which may lead to complications of its own, a new
and radical element has entered the picture.

One obvious difficulty with the procedure is that the
person affected, the infant male, has no say in what happens,
and now increasing numbers of adult males who were
circumcised at birth are protesting about male rights.

They have two aims. One is to prevent it happening to
other males, and the second is to explore methods of
restoring what was taken from them at birth.

These men claim not only that circumcision is traumatic to
the newborn but also that the removal of the protective
covering of the glans leads to keratinisation, a process
which begins immediately after the loss of the foreskin and
continues throughout life. Dr. Thomas Ritter, a US surgeon
who was an early campaigner against circumcision, says over
time the exposed glans takes on the character of external
skin rather than mucous membrane, becoming dry and
leathery.

It is said this toughening process causes loss of
sensitivity of the glans, reducing sensitivity during
sex.

In addition, circumcision is said to have other impacts on
sexual pleasure.

Loss of the foreskin is believed to have a much greater
impact on adult sexuality than has previously been
acknowledged.

Other circumcised men complain of life-long irritation of
the exposed glans as it comes in contact with clothing during
normal activity.

Some claim discomfort during masturbation when the exposed
glans is directly stimulated.

Some men are so angry about this involuntary surgery that
they refer to it as an assault, and equate it to genital
mutilation of the young female who is ritually circumcised
for religious or cultural reasons.

These men are attacking the issue on several fronts.

At a political level, groups such as NOCIRC and the NSW
[New South Wales] Men's movement are lobbying the Federal
Government [of Australia] for removal of the Medicare rebate
for circumcision.

In addition, they actively promote their views on
circumcision in the media in an attempt to influence parents
not to request the procedure, and at academic conferences to
encourage medical practitioners not to perform it.

The other, more personal, focus for men who feel they have
suffered because of their circumcision is the development of
techniques to restore a foreskin.

There are two basic techniques.

One was developed by Dr. James Bigelow, an American
psychologist, who in his mid 50s, began to experiment with
ways of redeveloping his foreskin.

He achieved this by gently and gradually stretching what
remained of his foreskin, keeping it in place with surgical
tape.

The tape was worn constantly and was cut is such a way as
to allow normal urination. It was removed for intercourse,
which Dr. Bigelow says interfered with spontaneous sex as he
tended to time sex for those days when he was going to change
the tape.

After four years he has a foreskin he is reasonably happy
with and hopes for further improvement over time.

He says his circumcision was severe, and therefore other
men way achieve a good result in significantly less time.

The stretching process can be aided by attaching small
weighted devices such as fishing weights to the tape.

Dr. Bigelow is trialling [sic] a cone-shape expansion
device which fits over the penis and allows for greater
tension of the expanding skin. The final result is not an
exact duplication of a normal foreskin, but is nevertheless
considered close enough to be worth the effort.

Dr. Bigelow's technique appears to have been
enthusiastically received by enough men in Australia to lead
to the development of a foreskin restoration self help
group.

The group, UNCIRC, offers a mail order service to supply
Dr. Bigelow's book, The Joy of Uncircumcising!, which
costs about $30 and takes about 2-3 months to arrive from the
US.

After the recipient has begun the program, the group has a
telephone advisory service on how to deal with any
difficulties is applying the technique.

The other approach to restoring foreskin is by surgery
using skin grafts. This has the advantage of providing a
quicker result with a greater amount of new tissue, and is
also popular in the US.

UNCIRC is lobbying the Federal Minister of Health to have
penile foreskin restoration covered by Medicare.

Those who have restored their foreskin say the glans
gradually becomes softer--more like mucous membrane. Sex
became more enjoyable and daily discomfort through friction
disappeared.

Whatever personal beliefs individual health providers may
have about the merits or otherwise of circumcision, they
could find themselves involved in debate about this practice
again, and the publicity that is building around restoration
procedures may lead to inquiries from patients as to what is
involved.

Clearly, the man (and probably his partner) need to be
highly motivated to persevere with the slow and tedious
procedure, but advocates claim the rewards are definitely
worth it.